An American nurse who is the only one to

serve the American Nurses Association (ANA) as

Executive Director and later as President

First published Nursing Theorist since

Florence Nightingale

Known to many as the “ Mother of Psychiatric

Nursing” and the “ Nurse of the Century”
 Personal
Born on September 1, 1909 and raised in Reading Pennsylvania by her
Background
parents of German descent, Gustav and Otyllie Peplau.
2nd daughter, with 2 sisters and 3 brothers
Though illiterate, her father was persevering while her mother was a
perfectionist and oppressive.
With her young age, Peplau’s eagerness to grow beyond traditional women’s
roles was precise. She considers nursing was one of few career choices for
women during her time.
In 1918, she witnessed the devastating flu epidemic that greatly influenced
her understanding of the impact of illness and death on families.
On March 17, 1999, she died peacefully in her sleep at home in Sherman
Oaks, California
Professional Journey
 Some of Hildegard Peplau’s works include:
Interpersonal Relations In Nursing: A Conceptual Frame of Reference for
Psychodynamic Nursing
Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E. Peplau
Basic principles of patient counseling ;: Extracts from two clinical nursing workshops in
psychiatric hospitals
A Glance Back in Time.: An article from: Nursing Forum
On Semantics.(psychiatric nursing): An article from: Perspectives in Psychiatric Care
The Psychiatric Nurse–Accountable? To Whom? For What?: An article from:
Perspectives in Psychiatric Care
Psychotherapeutic Strategies.: An article from: Perspectives in Psychiatric Care
 She was acknowledged with numerous awards and honors
Awards and for her contributions to nursing and held 11 honorary degrees
Honors
She was named one of “50 Great Americans” in Who’s Who
in 1995 by Marquis
Elected fellow of the American Academy of Nurse and
Sigma Theta Tau
Honored as a “Living Legend” by the American Academy of
Nursing in 1996
Received the “ Christiane Reimann Prize” (nursing’s highest
honor)
In 1998, the ANA inducted her into its Hall of Fame.
 Considers nursing to be a
“significant, therapeutic,
interpersonal process.” and define it
as:
The “human relationship between
an individual who is sick, or in need
of health services, and a nurse
specially educated to recognize and
to respond to the need for help”
Although she does not directly
address society/environment, she
does encourage the nurse to
consider the patient’s culture and
mores when the patient adjust to
the hospital routine
She defines man as an organism
that “strives in its own way to
reduce tension generated by needs.”
The client is an individual with a felt
need.
“ A word symbol that implies
forward movement of personality
and other ongoing human processes
in the direction of creative,
constructive, productive, personal
and community living”.
 Theory Overview
The interpersonal focus of Peplau’s theory requires that the nurse attend to the
interpersonal processes that occur between the nurse and client.
Peplau’s theory focuses on the interpersonal processes and therapeutic relationship
that develops between the nurse and client.
Interpersonal process is maturing force for personality. Interpersonal processes
include the nurse- client relationship, communication, pattern integration and the roles of
the nurse.
Psychodynamic nursing is being able to understand one’s own behavior to help others
identify felt difficulties and to apply principles of human relations to the problems that
arise at all levels of experience.
This theory stressed the importance of nurses’ ability to understand own behavior to
help others identify perceived difficulties.
 Four Phases of the therapeutic nurse-patient
relationship:
1. Orientation Phase
- The nurse’s orientation phase involves engaging the client
in treatment, providing explanations and information,
and answering questions.

Problem defining phase

It starts when the client meets the nurse as a stranger
Defining the problem and deciding the type of service
needed
Client seeks assistance, conveys needs, ask questions,
shares preconceptions and expectations of past
experiences.
Nurse responds, explains roles to the client, identifies
problems, and uses available resources and services
 Four Phases of the therapeutic nurse-patient
relationship:
2. Identification Phase
- The identification phase begins when the client works
interdependently with the nurse, expresses feeling, and
begins to feel stronger

Selection of appropriate professional assistance

Patient begins to have feeling of belonging and a
capability of dealing with the problem, which decreases
the feeling of helplessness and hopelessness.
 Four Phases of the therapeutic nurse-patient
relationship:
3. Exploitation Phase
- In this phase, the client makes full use of the services offered.

Use of professional assistance for the problem-solving

alternatives
Advantages of services are used based on the needs and interests
of the patients
The individual feels like an integral part of the helping
environment.
They may make minor requests or attention-getting techniques.
The principles of interview techniques must be used to explore,
understand and adequately deal with the underlying problem.
Patient fluctuate on independence
Nurse must be aware of the various phases of communication
Nurse Aids the patient in exploiting all avenues of help, and
progress is made towards the final step.
 Four Phases of the therapeutic nurse-patient
relationship:
4. Resolution Phase
- In this phase, the client no longer needs professional services and
gives up dependent behavior. The relationship ends.

Termination of professional relationship

The patient’s needs have already been met by the collaborative
effect of patient and nurse.
Now they need to terminate their therapeutic relationship and
dissolve the links between them
Sometimes may be difficult for both as psychological dependence
persists.
The patient drifts away and breaks the nurse’s bond, and a
healthier emotional balance is demonstrated, and both become
mature individuals.
 Roles of the Nurse in the Therapeutic
Relationship

Stranger Resource Teacher Leader Surrogate Counselor

person
-offering the -helping the -offering - Serving as -Promoting
client the -Providing client to learn direction to substitute for experiences
same specific formally or the client or another such leading to
acceptance answers to informally group as a parent or health for the
and courtesy questions a sibling client such as
that the within a expression of
nurse would larger feelings
respond to context
any stranger
Additional roles
Technical expert
include:
Consultant
Health teacher
Tutor
Socializing agent
Safety agent
Manager of environment
Mediator
Administrator
 Recorder observer
Researcher
 Application of Theory in Nursing Practice

Some of Peplau’s ideas were not widely accepted at the time they were
introduced. Such as the concepts of learning through experiences between the
patients and the students. At that time, her research and emphasis on the give-
and -take of nurse-client relationships was seen by many as new and
revolutionary. However, as the concepts that form her Interpersonal Relations
Model were applied and tested, many nursing experts now recall Peplau as the
one who brought a new perspective, a new approach and theoretical foundation
for nursing practice. Her ideas paved way for integrating other scientific
disciplines into nursing especially in formulating the paradigm of psychiatric
nursing in its early days.

In psychiatric Nursing, Peplau’s Interpersonal Model is used in counseling

women undergoing depression. Because of the maintained and strengthened
nurse-patient relationship, women were able to describe patterns that resulted
from their negative thinking and independently found strategies to manage
them.
 Application of Theory in Nursing Education

Hidegard Peplau’s book, Interpersonal Relations in Nursing(1951) is being used

as a manual of instruction to help graduate nurses and nursing students alike in
creating a significant nurse-patient relationship in any setting they are into.
Critiques of her model were published in numerous academic circles. Some
specializing in psychiatric nursing. Most comments of her works were published
two decades or more after they were initially published.

Her theoretical ideas, particularly her views of nursing and nursing process, the
psychodynamic theory, and her views of nursing and nursing process, the
psychodynamic theory and her prescribed methods, have been an essential part
of the collective culture of the nursing profession.
 Application of Theory in Nursing Research

At the arrival of the Interpersonal Model, nursing researchers follow the major
assumption that the patient problems were within the person phenomena and
were dealt inside the nurse-patient interaction studies. When her model was
slowly integrated research has shifted to perspective within the social system as
newer studies indicate that broader sets of relationship could also affect a person
in many ways. Peplau influenced upcoming leaders especially those in the
graduate school in the field of Psychiatric Nursing. The role of the nurse as a
stranger changed one’s view on anxiety as an important definition of stress and
its real effect on learning. Other psychiatric nurses developed a behavior scale
using Peplau’s conceptual framework and her assumptions in regards with the
therapeutic behavior of nursing experts were able to identify ways to reduce
anxiety and therefore, stress, in patients.
 ANALYSIS
a. Simplicity
- The major focus of Peplau’s theory, interpersonal relations, is easily
understood. The theory’s basic assumptions and key concepts were clearly
given, explained, broken down and outlined. In turn, she also demonstrated
how this model could be used as a process when she introduced the Four
Phases of Nurse-Patient Relationship. The different roles of the nurse added
further understanding on how nurses could effectively use the Interpersonal
Model by identifying which role is appropriate at a given phase or situation in
perfect harmony with the nursing process.
b. Generality
- Peplau believed that all nurses, regardless of their area or clinical setting, could
effectively utilize her model. However, the theory can be used only to situations
that communication can occur between the nurse and the patient. The use of
the model is limited or impossible in working with senile, comatose or newborn
patients. In these given situations, the nurse-patient relationship is often one-
sided. Knowing this, the nurse and the patient cannot work together to
develop goals and become more knowledgeable. For the nurse to function as an
educative, therapeutic and maturing force, understanding the meaning of the
experience to the patient is very important. This evaluative standard is not
met.
 ANALYSIS
c. Empirical Precision
-Peplau provides a theory based on reality. Her theory could be tested and
observed using pure observation. The relationship between the theoretical
area and empirical data could be validated and verified. Peplau functionally
categorizes the four phases of the interpersonal process, with the nurse’s
role taken into consideration together with the patient’s level of
dependence. We may consider Peplau’s theory to be precise but with
continued research and development, the degree of precision could be more
increased.
d. Derivable Consequences
- In historical perspective, Peplau is one of the first theorists after Florence
Nightingale to present a theory in nursing. Her works are highly regarded as
pioneering, and more so, widening the perception of nursing as a noble
profession.
Peplau’s works, thoughts, and ideas have greatly touched the lives
of many patients and nurses, from students to practitioners. Although her
work has been published five decades ago, it never ceases in providing the
direction for nursing practice, education and research. Peplau’s work has
provided a significant contribution to the profession.
 Assessment Nursing Planning Implementation Evaluation
(Orientation diagnosis (Identification (Exploitation (Resolution
phase) phase) phase) phase)
Mrs. JL is on pelvic Impaired physical Goal setting was done Carried out plans Mrs. JL was free to
traction and she is mobility related to the along with patient mutually agreed upon. express problems
restricted to bed. presence of pelvic regarding difficulty in
The need for bed rest traction. Patient will have mobilizing.
and restriction was improved physical Provided active and
discussed. mobility as evidenced by passive exercises to all She expressed
participating in self care the extremities satisfaction when able
Mrs. JL within the limits. to move without
27 years Made the patient to difficulty.
Provide active and perform breathing
Diagnosis: Inter
passive exercises to all exercises
vertebral disc the extremities to
prolapse improve the muscle Massaged the upper and
tone and strength. lower extremities
Provided article within
the reach of the patient
 References

https://currentnursing.com/nursing_theory/interpersonal_theory.html

https://www.slideshare.net/JannetElias/peplaus-interpersonal-relations-theory

Balita, Carl E.,Octaviano, Eufemia F. (2008). Sampaloc, Manila: Ultimate Learning Series

https://nurseslabs.com/hildegard-peplaus-interpersonal-relations-theory/

https://nursing-theory.org/nursing-theorists/Hildegard-Peplau.php

https://currentnursing.com/nursing_theory/application_Peplau%27s_interpersonal_theory.html